Working long hours, baby now screams when trying to nurse

Thanks in advance for any advice!

Baby is now 10 weeks old, and I've been back at work full-time for 2 weeks. He has been breastfed only, and has been growing great (weight tracking along 50-60%ile, height >90%ile). Here are my questions...

- I work long hours (~80 hours at work per week), and often "strange" hours - currently I'm working 16 hour shifts every other night (so I'm gone during the evening/night/morning every other day), although my schedule changes every few weeks. During the 16-hour shift right now, I only have time to pump 3 times - but I also pump or nurse immediately before and after my shift as well. With nursing right before I leave and as soon as I get home, baby will eat about 12-16 ounces while I'm gone. Does that sound about right? I'm able to pump 20-24 ounces in 3 pump sessions, so I always pump more than baby eats. So, I know that I should be pumping more than 3 times in a 16-hour shift, but I also don't want even more milk surplus (I've actually run out of room in the freezer, and already have >200 oz frozen!) If I keep this up, is my supply going to eventually disappear? Or is the 3 times pumping in 16 hours (or really, 5 times pumping/nursing in 16.5 hours) enough? I do try to nurse frequently when I'm home so that I get ~8 pumpings/nursings in per day.

- We usually nurse as part of baby's bedtime routine, and it used to go great. Since I've started working evenings/nights, husband now gives a bottle during the bedtime routine when I'm gone... but I'm home every other evening, so if I'm here then I'll nurse. In the past week, baby has started screaming and crying when I attempt nursing during the bedtime routine (he's hungry, and after quite a bit of soothing and shushing and multiple attempts at latching, he has finally latched and eaten well... after we both end up in tears however). The rest of the feeds during the day and at night are just fine... but baby gets so unhappy now during the bedtime feed! I'm not sure what's going on or how to fix it! I'd rather not give baby a bottle at bedtime if I'm here... but the crying and screaming when we try to nurse at bedtime just breaks my heart. Any advice??

Whew - sorry that was so long! Thanks for any advice / suggestions / support!

Re: Working long hours, baby now screams when trying to nurs

Are you a resident? I had my first as a surgical resident and had a very similar experience as far as crazy schedules.

1) In general, the rule of thumb is 1-1.5 oz/hour for each hour you are gone. So baby "should" be eating 16-24 ounces, but could be eating less, especially if he's nursing more frequently when you are around. Pumping 20-24 oz is great! You are early in your breast feeding and probably have some oversupply. Ideally you would pump every 3-4 hours, which if you nurse right before and after work, I think that works out to 3 pumps while at work, which should be fine. In my experience, I had over supply in the beginning, then my supply matched needs, then it dropped. If at all possible, I would continue to "over pump" at this point, because even though 200 oz seems like a ton now, by six to eight months you may be glad you have it. Many women have a eight month slump with pumping, and I found this to be very true. You seem like you are doing the best you can with a very crazy schedule. The over all goal of AT LEAST eight feeds or pumps in 24 hours is a good one.

2) Not sure about why baby is struggling with that feed -- one thing you can do is try to relax about it. One thing that worked for me with my second son is that when he was really tired, he'd get all worked up and wouldn't want to latch. I actually got him to relax by sucking on a pacifier for maybe 30 seconds, and then he'd latch fine. Maybe just snuggle for a bit before going for the latch? More than anything, don't take it personally. When they cry with latching, it makes a mother feel like they are rejecting you and your motherhood (which can feel like a knife in the heart when you add the guilt of being away for long hours while the baby is small) but they aren't. They are struggling with a physical process, one that they've only been practicing for 10 short weeks. Things are complicated because you've had to introduce a bottle, but you are smart and devoted, and with a gentle hand you'll be able to bring him back. I found that when things like this happened I got really tense, which was counter productive (though very difficult to avoid).

Hang in there! I have more ideas about crazy schedules, stress of pumping like that, etc if you have any more questions.

Some babies have a very hard time going back and forth from bottle to breast. This is called nipple or flow confusion and it can sometimes lead to breast refusal. The paced bottle feeding techniques described in links above are designed to help prevent this. Other things that may help are offering to nurse lots when with baby (cue feeding) and co-sleeping (either bed or room sharing) so baby has ample opportunity to nurse when you are there, day and night. Since you are only seeing an issue with nursing at one time of day, it has not become a big issue, yet. I would agree, no bottle when you are there to nurse. If baby does not want to nurse right at 'bedtime,' fine. He is doing what he wants to do, which is cry in your arms. Let baby cry in your arms and nurse when he will. This is probably what you would do if there simply were no separations or bottles, right? All babies cry and fuss and refuse to nurse on occasion, and it is usually not a big deal. this kellymom article has many great ideas for gently encouraging the reluctant-to-nurse baby. http://kellymom.com/bf/concerns/child/back-to-breast/

Last edited by @llli*lllmeg; November 11th, 2013 at 08:11 PM.
Reason: forgot something